HomeMy WebLinkAbout105347 ITRON INC - INSURANCE CERTIFICATE (4)o CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DD/YYYY)
08/29/2019
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER
Marsh USA. Inc.
1301 5th Avenue, Suite 1900
Seattle, WA 98101
Attn. Seat6e.CertRequest@marsh.com I FAX 212-948A326
C N 102835048-S T N D-GA W U E-19-
INSURED
Itron, Inc.
Attn: Yvonne Tanak
2111 N. Mokar Road
Liberty Lace, WA 99019-9469
GAWU
rnveoAr_ce rFRTIFIr_ATF NIIMRFR' SEA-003497535-09 REVISION NUMBER: 1
16535
WA
vTHIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
TYPE OF INSURANCE
A L
UBR
POLICY NUMBER
MM/DDPOLICY/WYY
MM/DDm
LIMITS
A
X
COMMERCIALGENERALLIABILITY
660BN120669-19
08/31/2019
08131/2020
EACH OCCURRENCE
$ 2,0D0,000
CLAIMS -MADE � OCCUR
DAMAGE TV KLN I LU
PREMISES Ea occurrence
$ 1,000,000
MED EXP (Any one n)
$ 10,000
PERSONAL 8 ADV INJURY
$ 2,000,000
GENT AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 4.000,000
PRODUCTS-COMP/OP AGG
$ 4,000,000
X PRO- ❑ LOC
POLICY ❑ JECT
OTHER.
B
AUTOMOBILE LIABILITY
CAP 1J668762-19
08/31/2019
08/3112020
Ea aBINED SINGLE LIMIT
$ 2,000.000
BODILY INJURY Per person)
$
X ANY AUTO
BODILY INJURY (Per accident)
$
OWNED SCHEDULED
AUTOS ONLY AUTOS
X HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
(Per accci enDAMAGE
$
ComplCdl Deductible
s 1,500
X
UMBRELLALJAB
X
OCCUR
US00086273LI19A
08/31/2019
08131/2020
EACH OCCURRENCE
$ 5,000,000
AGGREGATE
$ 5.000,000
EXCESS LIAB
CLAIMS -MADE
DEC) I X I RETENTION $10 000
$
D
WORKERS COMPENSATION
WC 0265072-01(AOS)
1010112016
T67-0172-01-9--_X
STATUTE ER
E.L. EACH ACCIDENT
$ 1,000,000
D
AND EMPLOYERS' LIABILITY YIN
ANVPROPRIE70R/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED9 N
(Mandatary in NH)
If yes. describe under
DESCRIPTION OF OPERATIONS below
NIA
WC 0265077-01 (WI)
10/01/2018
10/012019
E.L. DISEASE - EA EMPLOYEE
It 1000000
E.L. DISEASE -POLICY LIMIT
$ 1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
The City of Fort Collins, its officers, agents and employees shall be named as additional Insureds as it relates to general and auto liability in accordance with the terms and conditions of the policies. 30 day notice of
cancellation except for non payment of 10 days.
I-IUA It ML)LUtK
City of Fort Collins
City Clerk
PO Box 580
Fort Collins, CO 80522
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
of Marsh USA Inc.
Peggy Boren Q-?� ta!1W;L-*
ll Itfo O-LV to Mt Wrxu ...........
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD